Tacrolimus (FK506): validation of a sensitive enzyme-linked immunosorbent assay kit for and application to a clinical pharmacokinetic study.

Tacrolimus (FK506) is a macrolide immunosuppressant approved for the prophylaxis of organ rejection in liver transplant. Immunoassays of low intra- and interday variability and high sensitivity are necessary to adequately characterize terminal elimination phase concentrations in pharmacokinetic studies. A new ELISA kit for the quantitation of tacrolimus in human whole blood has been validated for use in pharmacokinetic studies. Methanol sample extracts were dried and reconstituted in a horseradish peroxidase (HPR)-FK506 conjugate solution. The reconstituted samples and mouse anti-FK506 were added to a microplate, precoated with secondary antibody, and incubated, FK506 and the HPR-FK506 conjugate competed to bind with anti-FK506, which was immobilized by binding to the secondary antibody. Unbound FK506 was washed away, and substrate was added for color development. Once the reaction was stopped with 2 N H2SO4, the plate was read at 450 nm. The linear range was 0.5-60 ng/ml, with a limit of quantitation of 0.5 ng/ml. Interday precision and accuracy were < or = 10.4% C.V. and < or = 3% R.E. for quality control samples. The lack of interference from endogenous compounds was established by parallelism and recoveries of FK506 from six lots of control matrix. Cross-reactivity against the metabolites and analogs were not performed because the kit monoclonal antibody was from the same source as Kobayashi et al (1). The utility and sensitivity of the kit present a good method for the quantitation of tacrolimus in blood from pharmacokinetic studies. The method is robust and has been used to assay tacrolimus in several thousand whole blood samples by multiple analysts.